Obesity is a complex public health issue that has only recently been acknowledged as having multiple factors including physical, psychological and genetic causes.

The relationship between obesity and work is complex. Routines and behaviours at work can influence eating and exercising habits, which will impact a person’s lifestyle and wellbeing, generally.

There is also the problem of how obese people are perceived. In the workplace obese employees often have to contend with stigma, prejudice, discrimination and bullying, which will impact on their performance and potential.

Research has shown that obese employees take more short- and long-term periods of sickness absence. According to Public Health England there are other significant workplace costs associated with obesity: For a large organisation employing 1000 people, lost productivity caused by obesity could cost more than £126,000 a year.

There is some evidence that obesity can increase the risk of some work-related injuries, namely

musculoskeletal disorders, stress and vibration induced injury. Repetitive movements can be problematic and can cause cumulative injuries such as osteoarthritis or carpel tunnel syndrome.

In light of these statistics employers might want to consider what steps they can take to tackle obesity related issues and how best they can support their employees. The workplace can play an effective, supporting role in the management and prevention of obesity, helping employees make better informed choices and move into sustainably healthy routines.

How Obesity is classified

Body mass index (BMI) is the most common way of identifying whether someone is a healthy weight or not. The NHS link can tell you what your BMI is and how this is classified if you know your weight and height, please refer to https://www.nhs.uk/live-well/healthy-weight/bmi-calculator/. For most people BMI is a useful indicator of obesity however BMI alone cannot definitively diagnose Obesity and so is used in combination with waist circumference.

You should lose weight if your waist circumference is more than 94cm in men or 80cm in women regardless of your height or BMI. If your waist circumference is more than 102cm in men or 88cm in women, then you are at a very high risk of multiple diseases and should see your GP.

Obese but healthy?

Can someone be classified as Obese but still be healthy? Well yes, someone with very little fat stores but very muscular may be classified as overweight or obese using BMI. And therefore, it is important to use waist circumference as well.

You may have read that people labelled overweight or mildly obese live longer than those with a normal weight or that being overweight can extend life rather than shorten it and in fact the research does support this, but this isn’t as simple as you might think.

These studies all used BMI alone to classify the participants as healthy weight, overweight or obese and as we have already said this is not a reliable predictor of body fatness, fat distribution, muscularity and health and wellbeing vs risk of death. It is important to note that lifespan doesn’t equate to quality of life. Research has proven that being even slightly overweight increases the risk of developing long-term health conditions which will affect one’s quality of life. So, while being overweight may not reduce your lifespan it can make life less enjoyable in the long term.

The research did also prove that while overweight and mildly obese people lived longer, those with grade 2 and 3 obesity were associated with significantly higher death rates.

Other reasons for why overweight or mildly obese individuals may live longer include the fact that people with more weight have fat reserves that can be used when losing weight due to illness or old age and the fact that high blood pressure and diabetes are routinely screened for in overweight individuals and so would receive treatment sooner than those of normal weight thereby reducing the incidence of complications.

The implications of Obesity in the workplace

Employers need to be non-judgemental when it comes to employees’ weight especially when the workplace plays a major role in influencing eating and exercise habits. The relationship between Obesity, stress and non-sedentary work is well understood.

The CIPD Health and Well-being at work Survey 2018 found the following:

• A high percentage of employees working while unwell
• Institutions reported a significant rise in mental health conditions (41% in 2016 to 55% in 2018)
• The most common causes of Long-term absence were:
  • Mental ill health (56%)
  • Musculoskeletal injuries (50%)
  • Stress (50%)
  • Acute medical conditions (48%)
  • Work/non-work-related injuries/accidents (19%)
• Employers are having more short- and long-term sickness absences
• Higher Loss of productivity
• Prejudice, discrimination and bullying found

In summary, a person may be well enough to show up to work and may even get the job done but would be even more productive if they are the healthiest, they can be.

What can employers do?

Occupational health, HR and employers can assist employees to make better informed choices and move into sustainably healthy routines.

Most straightforwardly that means providing the following opportunities for staff:

• Assisting employees to make better informed food choices by continuously promoting healthy choices in what’s offered in staff canteens, vending machines, events that involve foods and any visiting food providers. If the norm is sushi, salads and soups then the routine changes, followed by behaviour.
• Employers need to think creatively about how and when people get exercise during their working day. These solutions need to be practical and shouldn’t involve activities that require time, money or motivation. Employers can start by:
  • Encourage active lifestyles through active travel policy favouring walking or cycling
  • Secure parking sites for bicycles, showers and changing facilities.
  • Improve the look and environment around stairwells and use signage to encourage the use of stairs
  • Fitting offices with standing desks; encouraging more standing meetings or even walking meetings inside or out.
  • Developing links with local leisure centres and sports facilities to offer subsidised membership
• Wellbeing checks looking at weight, BMI & waist measurement, blood pressure, cholesterol, blood sugar and body composition, that provide education and advice, empowering employees to take control of their health

The first step is to identify what you want to achieve and obtain information relating to the workforce and the risks the employees are facing such as Obesity, Diabetes, Heart disease etc. For example, the purpose is to reduced sickness absence, improve productivity or improve resilience.

From there you can identify who will benefit from any intervention. Once you have identified the purpose and target group, a plan can be developed and implemented.

This will aid you in creating workforce specific goals. A workplace wellbeing initiative must be evidence based if you want it to be successful which is why it is so important to get a Dietician involved in the process right from the start.

It is important to change the culture of the organisation rather than just making superficial changes. A culture where a healthier working environment is key to the success of the initiative. This starts at the top with senior management buy-in and participation. It is also important to engage employees in the planning process so that they have ownership over the initiative and will then participate in the process.

At Staywell we can provide group talks with a Dietitian on a range of health topics or 1 on 1 consultations focusing on employee’s specific needs. And we have various paper and electronic resources at our disposal which can be distributed to employee’s for health education purposes.

Gayle Adams is a BDA (British Dietetic Association) registered Dietitian with over 14 years of experience. As a Staywell Dietitian she is passionate about designing and delivering innovative nutrition programmes to help people stay healthy at work. To speak to us about your health & wellbeing requirements call us on 0800 471 4941 or visit www.staywelloh.co.uk